<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address_id" data-rule="required" data-source="address/index" class="form-control selectpage" name="row[address_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_sn')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_sn" data-rule="required" class="form-control" name="row[order_sn]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_status" data-rule="required" class="form-control" name="row[order_status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Aftersale_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-aftersale_status" data-rule="required" class="form-control" name="row[aftersale_status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Consignee')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-consignee" data-rule="required" class="form-control" name="row[consignee]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address" data-rule="required" class="form-control" name="row[address]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Message')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-message" data-rule="required" class="form-control" name="row[message]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Goods_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-goods_price" data-rule="required" class="form-control" step="0.01" name="row[goods_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Freight_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-freight_price" class="form-control" step="0.01" name="row[freight_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_price" data-rule="required" class="form-control" step="0.01" name="row[coupon_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_price" data-rule="required" class="form-control" step="0.01" name="row[order_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Actual_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-actual_price" data-rule="required" class="form-control" step="0.01" name="row[actual_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_id" data-rule="required" data-source="pay/index" class="form-control selectpage" name="row[pay_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[pay_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ship_sn')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ship_sn" class="form-control" name="row[ship_sn]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ship_channel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ship_channel" class="form-control" name="row[ship_channel]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ship_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ship_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[ship_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refund_apply_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refund_apply_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[refund_apply_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('After_sales_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-after_sales_type" class="form-control" name="row[after_sales_type]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refund_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refund_amount" class="form-control" name="row[refund_amount]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refund_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refund_type" class="form-control" name="row[refund_type]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refund_content')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refund_content" class="form-control" name="row[refund_content]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Describe_credentials')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-describe_credentials" class="form-control " rows="5" name="row[describe_credentials]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refund_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refund_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[refund_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lock_version')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lock_version" class="form-control" name="row[lock_version]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Confirm_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-confirm_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[confirm_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Comments')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-comments" class="form-control" name="row[comments]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('End_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-end_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[end_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Store_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-store_id" data-rule="required" data-source="store/index" class="form-control selectpage" name="row[store_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Product_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-product_type" class="form-control" name="row[product_type]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lease_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lease_type" class="form-control" name="row[lease_type]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lease_term')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lease_term" class="form-control" name="row[lease_term]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('License_plate')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-license_plate" class="form-control" name="row[license_plate]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zstart_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-zstart_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[zstart_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zend_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-zend_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[zend_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_number" class="form-control" name="row[order_number]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Estimated_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-estimated_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[estimated_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Specifications')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-specifications" class="form-control " rows="5" name="row[specifications]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Refusal_to_refund_text')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-refusal_to_refund_text" class="form-control " rows="5" name="row[refusal_to_refund_text]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Delivery_code')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-delivery_code" class="form-control" name="row[delivery_code]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Return_code')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-return_code" class="form-control" name="row[return_code]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Delivery_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-delivery_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[delivery_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Frame_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-frame_number" class="form-control" name="row[frame_number]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lease_city')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class='control-relative'><input id="c-lease_city" class="form-control" data-toggle="city-picker" name="row[lease_city]" type="text" value=""></div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lease_address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lease_address" class="form-control" name="row[lease_address]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lease_mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lease_mobile" class="form-control" name="row[lease_mobile]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Deposit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-deposit" class="form-control" step="0.01" name="row[deposit]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Return_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-return_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[return_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('P_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-p_status" class="form-control" name="row[p_status]" type="number" value="1">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Is_door')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-is_door" class="form-control" name="row[is_door]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Q_user_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-q_user_id" data-rule="required" data-source="q/user/index" class="form-control selectpage" name="row[q_user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pickup_note_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pickup_note_number" class="form-control" name="row[pickup_note_number]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Deduction')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-deduction" class="form-control" step="0.01" name="row[deduction]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Commission')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-commission" class="form-control" step="0.01" name="row[commission]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Is_overtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-is_overtime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[is_overtime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Is_deduction')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-is_deduction" class="form-control" name="row[is_deduction]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Trailer_address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-trailer_address" class="form-control" name="row[trailer_address]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Store_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-store_name" class="form-control" name="row[store_name]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Trailer_longitude')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-trailer_longitude" class="form-control" name="row[trailer_longitude]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Trailer_latitude')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-trailer_latitude" class="form-control" name="row[trailer_latitude]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_location')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_location" class="form-control" name="row[user_location]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_longitude')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_longitude" class="form-control" name="row[user_longitude]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_latitude')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_latitude" class="form-control" name="row[user_latitude]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Rider_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rider_status" class="form-control" name="row[rider_status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('On_site_photos')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-on_site_photos" class="form-control " rows="5" name="row[on_site_photos]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Defective_vehicle_model')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-defective_vehicle_model" class="form-control" name="row[defective_vehicle_model]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_acceptance_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_acceptance_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[order_acceptance_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Arrival_time_of_vehicle')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-arrival_time_of_vehicle" class="form-control" name="row[arrival_time_of_vehicle]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Arrival_time_at_destination')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-arrival_time_at_destination" class="form-control" name="row[arrival_time_at_destination]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Appeal_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-appeal_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[appeal_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Reason_for_appeal')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-reason_for_appeal" class="form-control" name="row[reason_for_appeal]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Statement_description')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-statement_description" class="form-control " rows="5" name="row[statement_description]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Picture_of_appeal')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-picture_of_appeal" class="form-control " rows="5" name="row[picture_of_appeal]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Q_appeal_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-q_appeal_status" class="form-control" name="row[q_appeal_status]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Installation_fee')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-installation_fee" class="form-control" step="0.01" name="row[installation_fee]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Delivery_fee')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-delivery_fee" class="form-control" step="0.01" name="row[delivery_fee]" type="number" value="0.00">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pickup_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pickup_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[pickup_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Deliveryd_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-deliveryd_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[deliveryd_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Service_completion_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-service_completion_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[service_completion_time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Unlock_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-unlock_type" class="form-control" name="row[unlock_type]" type="text" value="">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
